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spinemonitor: Neck & Back Pain eNewsletter from SpineUniverse.com
spineuniverse.com/professional November 28, 2007
New Surgical Case Study
Degenerative Disc Disease in a 30 Year-old Female

History:
This 30 year-old female presented with low back pain that started 6 months ago.  Activity makes her pain worse. She reports back pain as 8/10 and thigh pain as 5/10 without pain distal to the knee.  Her Oswestry Disability Index is 50%. The patient does not have a history of trauma.

Previous treatment consisted of physical therapy, core stabilization exercises, and NSAIDs.

Examination:
On physical examination, the patient reported low back tenderness and lumbar pain with range of motion. She is neurologically intact. 0/5 Waddell signs.

Diagnosis
:
The patient has degenerative disc disease at L4-L5...Read Complete Case and View Outcome

Degenerative Disc Disease

Fig. 2B: Lumbar extension shows minimal retrolisthesis at L4-L5.
Click here for Larger Image

Click Here to Answer
Photo: David W. Polly, Jr., M.D. Case Author:
David W. Polly, Jr., M.D.
Professor and Chief of Spine Service
University of Minnesota
Department of Orthopaedic Surgery
Minneapolis, MN
Sponsored by: Biowave
Biowave - Percutaneous
Past Spine Cases:
Below is a listing of previous spine case studies. Feel free to browse and vote for treatment options for each case.
Cervical Pseudoarthrosis and Adjacent Level Disease
By: Jason M. Highsmith, MD

Adult Onset Scoliosis
By: Amir A. Mehbod, MD

Spinal Stenosis – Unresponsive to Nonoperative Treatment
By: Jason M. Highsmith, MD

Pseudofusion Dilemma
By: Jason M. Highsmith, MD

Reactive Scoliosis
By: Amir A. Mehbod, MD
HIBBS Award Paper
Largest reported series on posterior VCR in North America
Posterior Vertebral Column Resection (VCR) for Severe Pediatric and Adult Spinal Deformity: Indications, Results, and Complications of 43 Consecutive Cases
Lawrence G. Lenke, M.D. by Lawrence G. Lenke, M.D.
The Jerome J. Gilden Professor of Orthopedic Surgery
Co-Chief Pediatric & Adult Spinal, Scoliosis & Reconstructive Surgery
St. Louis, MO

The surgical treatment of severe spinal deformity is challenging. Traditionally, a circumferential approach with anterior releases via discectomies, followed by posterior instrumentation and fusion has been the standard of care.  The purpose of this study was to examine the indications, correction rates, perioperative and postoperative morbidity and complications of an all-posterior VCR approach for the treatment of severe pediatric and adult spinal deformity by a single surgeon.  This is the first largest reported series on posterior vertebral column resections thus far, and the first from a North American center.... Read More

View Complete Article

Featured Event
ONE Spine: Controversies in Spine Surgery
February 8th – 9th, 2008
Ritz-Carlton Hotel,
Cancun, Mexico

Arthroplasty vs. fusion vs. motion sparing, common adult deformity challenges, aging spine and trauma, candid debates, in-depth case discussions, interactive workshops, and quality surgical videos.
Weill Cornell Medical College

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